922 KAR 2:090 · 922 KAR 2:090. Section 8. General.

General: Based on observation, the health, safety, and comfort of children in the preschool room located in the building at the end of the covered breezeway were jeopardized due notations on the dry erase board identifying a child by name and the child's behaviors under the title, "Bad". Although children were not present in the room at the time of observation, interview confirmed that the room is regularly utilized.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on observation, the center failed to maintain compliance with minimum staff-to-child ratio and maximum group size requirements based on the following occurrences: Infant Classroom: 1. There were six (6) infants with one (1) staff member, the youngest infant was ten (10) months old. Therefore, the minimum staff-to-child ratio was exceeded by one (1) child. Older Ones Classroom: 1. There were thirteen (13) one-year-old children present with three (3) staff members. The maximum group size for that age group was exceeded by one (1) child.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on interview and review of documentation, the following was determined: 1. A staff member (DOH: 04.08.24) completed zero (0) training hours during the last review period. Additionally, the staff member failed to complete six (6) hours of cabinet-approved orientation training during the first ninety (90) days of employment; 2. A staff member (DOH: 08.09.23) completed zero (0) training hours during the review period; 3. A staff member (DOH: 06.09.25) only completed four (4) hours of training during the review period; 4. A staff member (DOH 09.20.21) completed two (2) hours of training during the review period; 5. A staff member (DOH: 06.05.23) only completed four (4) hours of training during the review period; and 6. A staff member (DOH: 02.22.23) only completed four (4) hours of training during the review period.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on observation and interview, preschool children were asked to sit on an area rug and watch the television during 'rest time. Interview confirmed that children are asked to watch a movie or other screened program for up to one and one half (1 1/2) hours during the designated 'rest time'. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 13 of 34 Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 5. Infant and Toddler Play Requirements.

General: Based on observation and interview, toddlers (2y/o) were combined with older children (3y/o) in the following classrooms: Twos/Threes Potty room; Twos/Threes diaper room; and Twos room. No written transition plans were available for review

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 4. Premises Requirements.

General: Based on observation in the hallway within the school building, a gas burning heater installed in the wall was actively burning. The heater was not protected from access.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 4. Premises Requirements.

General: Based on observation, the following was determined: Ones' Classroom: 1. There were multiple sections of the walls that contained areas of peeling and chipped paint. Twos/Threes Diapers Classroom: 1. There were areas of chipping paint on the purple wall.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation, there was no soap available near the sink located in the toilet room adjacent to the Twos' classroom.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation, the toilet in the toilet room adjacent to the Twos' classroom did not flush. When flushed, the water rose, but the toilet tissue did not go down. Hygienic Practices Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation in the Ones' Classroom, the diaper changing surface was no longer nonabsorbent and in good repair as it contained a tear, exposing the inner absorbent material.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 6. Sleeping and Napping Requirements.

General: Based on observation in the Infant classroom, the following was determined: 1. The first crib, adjacent to the door, contained a loose-fitting sheet that appeared to be intended for a larger crib mattress. Interview confirmed that although the crib was not being used on the day of the inspection, it has been used in the same manner as it was observed. 2. A crib mattress in a white crib positioned against the wall failed to be in good repair. The mattress bowed upward, creating an elevated arch in the center of the mattress.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 6. Sleeping and Napping Requirements.

General: Based on observation and interview, rest time in the preschool room consisted of all children sitting on an area rug and watching a moving for up to one and one half (1 1/2) hours. Interview confirmed that cots are only provided to a child upon the request of the child.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 13. Toys and Furnishings.

General: Based on observation in the Ones' Classroom, the integrity of the wooden changing table was jeopardized due to a missing lower shelf. The table wobbled when lightly touched.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 13. Toys and Furnishings.

General: Based on observation, the following was determined: Infant classroom: 1. A blue Bumbo seat was stored on an open shelf. The seat did not contain the straps provided by the manufacturer. Older Ones' Classroom: 1. The upper wooden surface of the changing table was not clean, it contained a collection of food crumbs and pieces of cereal.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 13. Toys and Furnishings.

General: Based on observation, in the Two/Three Diapers classroom, multiple of stuffed animals were soiled and discolored on the outer surfaces.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 8. Kitchen Requirements.

General: Based on observation the following was determined: Ones' Classroom: 1. The internal temperature within the refrigerator was fifty-two (52) degrees Fahrenheit, as determined by the thermometer inside the refrigerator. A jug of milk, containers of juice, and children's cups were stored in the refrigerator. Area between the Preschool classroom and the Two/three Potty classroom: 1. The mini-refrigerator was heavily soiled with a splattered, unknown substance on the inner and outer surfaces.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.

General: Based on review of documentation, one (1) of the ten (10) reviewed children's files failed to contain contact information for the preferred hospital and an identified family physician.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 3. General Requirements.

General: Based on interview and review of documentation, the documenation of completed fire drills for the last half of 2025 failed to be complete. Some documented drills included the names of the children who participated in the drill; however, no times for the drills were documented. Additionally, interview confirmed that no fire drill was conducted in January of 2026.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 7. First Aid and Medicine.

General: Based on review of documentation, based on review of ECE-TRIS, the surveyor found that the following staff (DOH: 03/25/24, 06/05/24, 08/22/24 and 05/13/25) had not completed the required cabinet approved training in first aid and cardiopulmonary resuscitation (CPR).

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:280 · 922 KAR 2:280. Section 3. Implementation and Enforcement.

General: Based on review of documentation, the surveyor found that a staff’s (DOH: 03/10/25) file contained documentation of a background check submitted through KARES that verified the staff’s eligibility date as 05/29/24. Upon review of the child-care center's KARES Report, the surveyor found the staff person listed as "separated." The surveyor observed the staff person to be working with children on the day of the surveyor's visit. During interview with staff-in-charge, she confirmed that the staff person mentioned was a re-hired employee and she had not conducted new fingerprints. She stated that the KARES eligibility page was from the staff person's previous employment with the child-care center.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:280 · 922 KAR 2:280. Section 11. Status of Employment.

General: Based on review of documentation, the surveyor found a staff (DOH: 03/10/25) file that contained documentation from KARES that the staff person was eligible for hire on 05/29/24. On the day of visit, the surveyor printed the child-care center’s KARES report and reviewed the names listed and noticed that the staff person was not listed under the childcare center’s roster; therefore, the child-care center failed to update the staff person’s employment status. The surveyor reviewed the child-care center's KARES report and found that the staff person had been listed as "separated." An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 4 of 35 Inspection Report Supervision Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on observation, the surveyor found upon arrival to the child-care center at 1:24 pm on 06/04/25, the surveyor was unable to enter the building. The surveyor rang the doorbell and attempted to call the child-care center several times. While the surveyor was standing at the front door, the surveyor was able to see inside to the child-care center and observed a child running down the hallway, unsupervised. The surveyor was able to hear an adult yelling through the door, advising children to go to the "Cleaning Room." The surveyor observed three (3) more children to run down the hallway at 1:33 pm. During this time, the surveyor continued to ring the doorbell, knock on the door and attempt to call the child-care center. At 1:34 pm, the surveyor was greeted by a staff person, who allowed the surveyor to enter the lobby of the building. The surveyor observed children to continue running down a hallway and into the Preschool Classroom, where the children shut the door and left the staff person in the hallway. The surveyor interviewed the staff person who opened the child-care center entrance and found that she was working alone with six (6) children and that all the children in her care were five-year-old children. She stated that she had been in the hallway restroom helping another child, when five (5) of her students continued to run up and down the hallway and into the Preschool Classroom, unsupervised; therefore, the child-care center failed to ensure that adequate supervision and failed to ensure that the preschool age children were within eye sight and range of voice at all times.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 10. Director Requirements and Responsibilities.

General: Based on observation, the surveyor found upon arrival to the child-care center at 1:24 pm on 06/04/25, the surveyor was unable to enter the building. The surveyor rang the doorbell and attempted to call the child-care center several times. While the surveyor was standing at the front door, the surveyor was able to see inside to the child-care center and observed a child running down the hallway, unsupervised. The surveyor was able to hear an adult yelling through the door, advising children to go to the "Cleaning Room." The surveyor observed three (3) more children to run down the hallway at 1:33 pm. During this time, the surveyor continued to ring the doorbell, knock on the door and attempt to call the child-care center. At 1:34 pm, the surveyor was greeted by a staff person, who allowed the surveyor to enter the lobby of the building. The surveyor observed children to continue running down a hallway and into the Preschool Classroom, where the children shut the door and left the staff person in the hallway. The surveyor interviewed the staff person who opened the child-care center entrance and found that she was working alone with six (6) children and that all the children in her care were five-year-old children. She stated that she had been in the hallway restroom helping another child, when five (5) of her students continued to run up and down the hallway and into the Preschool Classroom, unsupervised; therefore, the child-care center failed to ensure that adequate supervision and failed to ensure that the preschool age children were within eye sight and range of voice at all times. During review of documentation, the surveyor found that the staff person's file did contain documentation from KARES that the staff person had an eligibility date of 05/29/24; however, the staff person was listed as "separated" under the child-care center's KARES roster. During interview with staff-in-charge, she confirmed that the staff person had left the child-care center and was a re-hired employee. She stated that she had not reran fingerprints on the staff-person and that the KARES eligibility form was from her previous employment through the child-care center. The surveyor did observe the staff person to be working alone with children in the Preschool Classroom on the day of the surveyors visit.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on review of documentation, the surveyor found that the following staff (DOH: 03/12/25 and 03/17/25) files did not contain verification of a High School Diploma, GED or Commonwealth Child Care Credential. During interview with staff-in-charge, she stated that the documents were not on file.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on review of documentation, the surveyor found that the following staff (DOH: 03/27/23 and 03/05/24) files did not contain documentation of a current TB skin test or a statement from a health professional stating that the adult was free from active tuberculosis. During interview with staff-in-charge, she stated that both staff mentioned had not received new TB skin test.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on review of documentation, the surveyor found the following: 1. Based on review of ECE-TRIS, the following staff (DOH: 03/25/24, 06/05/24, 08/22/24, 12/05/24 and 12/16/24) did not have documentation that Orientation was completed within the first three (3) months of hire. 2. Based on review of ECE-TRIS, one (1) staff person (DOH: 05/13/24) did not have documentation that Orientation was completed within the first three (3) months of hire. The surveyor reviewed ECE-TRIS and confirmed that the staff person had a first-year start date of 10/10/23, 3. Based on review of ECE-TRIS, one (1) staff person (DOH: 06/20/21) file did not contain documentation of one and one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma training; therefore, the training was not completed within one (1) year of employment. 4. Based on review of ECE-TRIS, one (1) staff person (DOH: 06/20/21) completed zero (0) hours of the required fifteen (15) hours of cabinet-approved early care and education training completed between 07/01/23 - 06/30/24. 5. Based on review of ECE-TRIS, one (1) staff person (DOH: 01/13/22) completed ten and a half (10.5) hours of the required fifteen (15) hours of cabinet-approved early care and education training completed between 07/01/23 - 06/30/24. 6. Based on review of ECE-TRIS, one (1) staff person (DOH: 03/27/23) completed six (6) hours of the required fifteen (15) hours of cabinet-approved early care and education training completed between 03/28/24 - 06/30/24. 7. Based on review of ECE-TRIS, one (1) staff person (DOH: 06/26/23) completed zero (0) hours of the required fifteen (15) hours of cabinet-approved early care and education training completed between 06/26/23 - 06/26/24. 8. Based on review of ECE-TRIS, one (1) staff person (DOH: 08/29/23) completed zero (0) hours of the required fifteen (15) hours of cabinet-approved early care and education training completed between 08/29/23 - 08/29/24. 9. Based on review of ECE-TRIS, one (1) staff person (DOH: 03/05/24) completed zero (0) hours of the required fifteen (15) hours of cabinet-approved early care and education training completed between 03/07/24 - 06/30/24. The surveyor reviewed ECE-TRIS and confirmed that the staff person had a first year start date as 03/07/23. 10. Based on review of ECE-TRIS, one (1) staff person (DOH: 03/25/24) completed five (5) hours of the required fifteen (15) hours of cabinet-approved early care and education training completed between 03/25/24 - 03/25/25. 11. Based on review of ECE-TRIS, one (1) staff person (DOH: 08/22/24) completed three (3) hours of the required fifteen (15) hours of cabinet-approved early care and education training completed between 10/11/23 - 06/30/24. The surveyor reviewed ECE-TRIS and confirmed that the staff person had a first-year hire date of 10/11/22, 12. Based on review of ECE-TRIS, one (1) staff person (DOH: 05/13/25) completed two and a half (2.5) hours of the required fifteen (15) hours of cabinet-approved early care and education training completed between 10/10/23 - 10/10/24. The surveyor reviewed ECE-TRIS and found that the staff person had a first-year hire date of 10/10/23.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation, the surveyor found that the changing table in the Infant Classroom, Ones Classroom, Ones Classroom and the Twos/Threes Classroom was not adjacent to a sink. The surveyor observed that each classroom had a changing table placed in the actual classroom and that the sink was located in a hallway behind a closed door. During interview with staff-in-charge, she stated that she had heard different information regarding where the diaper changing table should be placed at.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation, the surveyor found that the third stall toilet in the hallway girls' restroom was stuffed with toilet paper and was unable to be flushed; therefore, the toilet was not kept in good repair. Hygienic Practices Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 3. General Requirements.

General: Based on observation, the surveyor found upon entering the One's Classroom at 2:16, a staff person to be changing a child's diaper. The surveyor observed the staff person to finish the diaper change, pick up the child and place the child on the floor. The surveyor observed the staff person to then carry the dirty diaper and open the classroom door that exits to the outside, where the staff person then threw away the diaper. The surveyor observed the staff person to then pick up another child and place the child on the changing table and to begin changing his diaper. The surveyor did observe there to be a sink in the hallway behind a closed door. The surveyor did not observe the staff person to wash the children's hands after they had their diaper changed. During interview with staff-in-charge, she confirmed that the children who had their diaper changed were sixteen (16) months old and fifteen (15) months hold. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 19 of 35 Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 3. General Requirements.

General: Based on observation, the surveyor found upon entering the One's Classroom at 2:16, a staff person to be changing a child's diaper. The surveyor observed the staff person to finish the diaper change, pick up the child and place the child on the floor. The surveyor observed the staff person to then carry the dirty diaper and open the classroom door that exits to the outside, where the staff person then threw away the diaper. The surveyor observed the staff person to then pick up another child and place the child on the changing table and to begin changing his diaper. The surveyor did observe there to be a sink in the hallway behind a closed door and a diaper changing policy hanging on the wall. The surveyor did not observe the staff person to wash her hands after the first or second diaper change. During interview with staff-in-charge, she confirmed that the children who had their diaper changed were sixteen (16) months old and fifteen (15) months hold.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation, the surveyor found the following: 1. There were food crumbs on the diaper changing table underneath the diaper changing pad in the Infant; therefore, the diaper changing surface was not kept clean. 2. There was debris on the diaper changing table underneath the diaper changing pad in the Ones Classroom; therefore, the diaper changing surface was not kept clean.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation, the surveyor found upon entering the One's Classroom at 2:16, a staff person to be changing a child's diaper. The surveyor observed the staff person to finish the diaper change, pick up the child and place the child on the floor. The surveyor observed the staff person to then carry the dirty diaper and open the classroom door that exits to the outside, where the staff person then threw away the diaper. The surveyor observed the staff person to then pick up another child and place the child on the changing table and to begin changing his diaper. The surveyor did not observe the staff person to be wearing gloves. The surveyor did observe there to be a diaper changing policy hanging on the wall that stated staff must wear gloves. During interview with staff-in-charge, she confirmed that the children who had their diaper changed were sixteen (16) months old and fifteen (15) months hold.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 4. Premises Requirements.

General: Based on observation, the surveyor found that the protective surface underneath the swing set was depleted of the woodchips that was being used for the fall zone area.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.

General: Based on review of documentation, the surveyor found the following: 1. A child’s (DOE: 01/03/22) file contained an immunization certificate that was no longer current as of 04/01/25. 2. A child’s (DOE: 05/30/22) file contained an immunization certificate that was no longer current as of 04/09/25.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 3. General Requirements.

General: Based on review of documentation, the surveyor found that the child-care center failed to conduct and document the monthly required fire drills for January and April 2025. During interview with staff-in-charge, she stated that the child-care center had not conducted the fire drills.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 10. Director Requirements and Responsibilities.

General: Based on observation, the surveyor found upon arrival to the child-care center at 1:24 pm on 06/04/25, the surveyor was unable to enter the building. The surveyor rang the doorbell and attempted to call the child-care center several times. While the surveyor was standing at the front door, the surveyor was able to see inside to the child-care center and observed a child running down the hallway, unsupervised. The surveyor was able to hear an adult yelling through the door, advising children to go to the "Cleaning Room." The surveyor observed three (3) more children to run down the hallway at 1:33 pm. During this time, the surveyor continued to ring the doorbell, knock on the door and attempt to call the child-care center. At 1:34 pm, the surveyor was greated by a staff person, who allowed the surveyor to enter the lobby of the building. The surveyor observed children to continue running down a hallway and into the Preschool Classroom, where the children shut the door and left the staff person in the hallway. The surveyor interviewed the staff person who opened the child-care center entrance and found that she was working alone with six (6) children and that all the children in her care were five-year-old children. She stated that she had been in the hallway restroom helping another child, when five (5) of her students continued to run up and down the hallway and into the Preschool Classroom, unsupervised. The surveyor followed the staff person into the Preschool Classroom and observed six (6) children to be playing, running around the classroom and yelling. The surveyor walked over to the next classroom (Preschool #2 Classroom) and observed nine (9) children to be asleep on cots. The surveyor asked the staff person if the schedule posted was for both Preschool Classrooms. The staff person stated that it was rest time from 12:30 - 2:30 pm, however the Preschool Classroom next door was out of control; therefore, the child-care center failed to follow the posted daily schedule.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on observation, the surveyor found the following: 1. During the initial walkthrough of the child-care center, the surveyor observed there to be nine (9) children with one (1) staff person in the Infant #1 Classroom. The surveyor confirmed with the staff person in the classroom that the youngest child present was six (6) months old and that the staff person had been left alone with the children for approximately twenty (20) to thirty (30) minutes; therefore, the staff-to-child ratio was exceeded by four (4) children. 2. During the initial walkthrough of the child-care center, the surveyor also observed there to be fifteen (15) children with (1) staff person in the Three’s Classroom. The surveyor confirmed with the staff person in the classroom that the youngest child was three (3) years old and that the staff person had been left alone with the children for approximately thirty (30) minutes; therefore, the staff-to-child ratio was exceeded by three (3) children. General Administration Not In Compliance

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 6. License Issuance.

General: Based on interview, the surveyor found that the child-care center does not allow parents to have access to the classrooms during the day and that parents must wait in their vehicles during morning drop-off and afternoon pick-up. The surveyor found through multiple interviews that staff believed that this was due to safety concerns and/or due to a state regulation. Through review of documentation of the parent handbook that was provided by the child-care center, the surveyor found that the child-care center escorts children to their classroom from the parent's vehicle. During interview with staff, the surveyor also found that if a parent attempts to come into the classrooms, parents are stopped by the director or assistant director; therefore, the child- care center failed to allow parents of enrolled children to have unannounced access to the child-care center during hours of operation.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 8. General.

General: Based on observation, the surveyor found that a staff’s file contained documentation of a background check submitted through KARES that verified the staff’s eligibility date as 06/18/24. The documentation verified that the staff person was listed under KARES as a staff person under the age of eighteen (18) and that the staff person had only had a Child Abuse/Neglect Background Check (CAN). The surveyor verified through documentation found in the staff person's file and confirmed that the staff person was under the age of eighteen (18). The surveyor observed the staff person working alone with children in Infant #1 Classroom on the day of the visit for approximately twenty (20) to thirty (30) minutes with nine (9) infants. Through interview with the staff person, the surveyor found that the youngest infant in the classroom was six (6) months old. During interview with staff-in-charge, the surveyor asked if she was aware that the staff person was under the age of eighteen (18) and that she had been left alone in the Infant #1 Classroom. Staff-in-charge stated that she was not aware that the staff person was under the age of eighteen (18) due to her filling in for the director that day. Director Requirements Discussed An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report Employee Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on review of documentation, the surveyor found that the following staff (DOH: 03/11/24 and 03/25/24) file did not contain verification of a High School Diploma, GED or Commonwealth Child Care Credential prior to employment. During interview with staff-in-charge, she stated she was not sure where the documentation was located at.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on review of documentation, the surveyor found the following staff (DOH: 01/14/22, 06/26/23 and 05/29/24) file did not contain documentation of a current TB skin test or a statement from a health professional stating that the adult was free from active tuberculosis. During interview with staff-in-charge, she stated that she did not have the documentation at this time. Equipment In Compliance Food Service Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 9. Food and Drink Requirements for All Child-Care Centers.

General: Based on interview, the surveyor found that children in the One's Classroom, Two's Classroom and Three's Classroom would often stand around during breakfast time instead of being offered a chair to sit in. The surveyor found through multiple interviews that the reason being is because the children often like to play, walk around and eat at the same time. The surveyor also found through interview that the Preschool Classroom would also stand around a table during snack time instead of being offered chairs to sit in. The surveyor walked to the Three’s Classroom to observe snack at 2:48 pm with the staff-in-charge. The surveyor observed there to be nine (9) children present at this time participating in eating chocolate pudding for snack. The surveyor observed all nine (9) children to be standing around a table and did not observe chairs around the table. The surveyor asked the staff present if chairs had been offered and the surveyor was informed that chairs had not been placed out for snack. Therefore, the child-care center failed to ensure that children are served meals while seated.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 4. Premises Requirements.

General: Based on observation, the surveyor found the following on the playground: 1. Grass and weeds were growing up through the black material that was placed underneath the mulched area; therefore, the playground was not well maintained. 2. Grass was high and growing upward at the base of the fence row on the fence that surrounds the playground; therefore, the playground was not well maintained. 3. A trampoline was in the back corner of the playground area and accessible to the children; therefore, the playground was not safe from a potential foreseeable hazard.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 4. Premises Requirements.

General: Based on observation, the surveyor found the mulch was depleted throughout the playground. The area surrounding the newly added equipment did not have an adequate fall zone as the mulch was depleted; therefore, the child-care center failed to ensure that the playground had an adequate fall zone. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Equipment In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on observation, the surveyor found the following: 1. Through review of video footage, the surveyor found that on 04/19/24 there was one (1) staff alone in the One's Classroom with ten (10) children for one (1) minute and nineteen (19) seconds. The surveyor confirmed with staff that the youngest child present on 04/19/24 was seventeen (17) months old; therefore, the staff person was out of ratio by four (4) children. 2. Through review of video footage, the surveyor found that on 04/19/24 there was one (1) staff alone in the One's Classroom with eight (8) children for five (5) minutes and two (2) seconds. The surveyor confirmed with staff that the youngest child present on 04/19/24 was seventeen (17) months old; therefore, the staff person was out of ratio by two (2) children 3. Through review of video footage, the surveyor found that on 04/19/24 there was one (1) staff alone in the One's Classroom with eight (8) children for thirty-nine (39) seconds. The surveyor confirmed with staff that the youngest child present on 04/19/24 was seventeen (17) months old; therefore, the staff person was out of ratio by two (2) children 4. Through review of video footage, the surveyor found that on 05/09/24 there was one (1) staff alone in the One's Classroom with twelve (12) children for fifty-three (53) seconds. The surveyor confirmed with staff that the youngest child present on 05/09/24 was seventeen (17) months old; therefore, the staff person was out of ratio by six (6) children. During interview with staff-in-charge and review of the attendance records, the surveyor confirmed that there was only one (1) staff present from 7:30 am - 3:45 pm with twelve (12) children on 05/09/24. Staff-in-charge confirmed that the youngest child was seventeen (17) months old. Staff-in-charge also stated that there was only one (1) staff person on 05/09/24 from 3:45 pm - 6:00 pm with nine (9) children who was one (1) years old. Staff-in-charge informed the surveyor that she was aware that the classroom was out of ratio and she stated that she was "working on it." General Administration Not In Compliance

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 6. License Issuance.

General: Based on interview and review of documentation, the surveyor found through multiple interviews and review of the child-care center's parent handbook that parents are not granted access to the child-care center throughout the day. The surveyor found that parents of enrolled children do not exit their vehicles during drop off or pick up and that a staff person will escort children to the appropriate classroom. The surveyor also found that parents are not allowed to enter the classrooms of their enrolled children and that they must wait in their vehicles due to safety concerns; therefore, the child-care center failed to allow access to parents of enrolled children at the child-care center.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 8. General.

General: Based on observation and interview, the surveyor found through multiple interviews and through review of video footage that on 04/19/24 an eighteen (18) month old child was in the One's Classroom when several children were rough housing and hitting the child with a toy. The surveyor was also presented with incident reports that indicated that the child had been bitten by a child while in the classroom. The surveyor reviewed video footage from 05/09/24 and found that the eighteen (18) month old child was around another child that appeared to place her mouth on the child's face several times. The surveyor was given an incident report for the child being bitten on 05/09/24. The surveyor found through several interviews that the eighteen (18) month old child had markings on his face that indicated that he had been bit; therefore, the health, safety and comfort of the child was compromised. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report Employee Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on review of documentation, the surveyor found that the following staff (DOH: 03/05/24, 03/11/24, 03/25/24 and 04/30/24) files did not contain verification of a High School Diploma, GED or Commonwealth Child Care Credential.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on review of documentation, the surveyor found a staff’s (DOH: 04/30/24) file did not contain documentation of a current TB skin test or a statement from a health professional stating that the adult was free from active tuberculosis.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on observation, the surveyor witnessed a child walk down the hallway and enter the restroom unsupervised. The surveyor asked the staff-in-charge if the child belonged in her classroom and the staff-in-charge did not know which classroom the child supposed to be in. Staff-in-charge opened the restroom door and asked the child if he was ok. The child came out of the restroom and the staff-in-charge began walking with the child. The surveyor asked staff-in-charge if the child belonged in the Four’s Classroom. Staff- in-charge confirmed that the child was supposed to be in the Four’s Classroom. Staff-in-charge confirmed that the child was five-years-old. Thus, the child-care center failed to ensure that the child was within scope of vision and range of voice of a qualified staff member when the child went to the restroom alone. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 5 Inspection Report Staffing Requirements Not In Compliance

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on observation and interview, the surveyor discovered one (1) staff member was providing care for sixteen (16) four-year-old children in the Four’s Classroom; therefore, the staff-to-child ratio was exceeded by two (2) children. The staff member in the classroom confirmed the age of the children inside the Four’s Classroom. Staff-in-charge stated that two (2) staff members were working in the classroom; however, one (1) staff member had stepped out of the classroom to take an emergency phone call. General Administration Not In Compliance

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 8. General.

General: Based on observation, the surveyor found a child enter and exit a restroom wearing no shoes; therefore, the health, safety, and comfort of the child was compromised. The surveyor observed the child to be wearing socks. Employee Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on review of documentation, the surveyor discovered that the personnel file of one (1) staff member (DOH: 02/20/24) did not contain documentation of education in the form of a high school diploma, GED, or Commonwealth Child Care Credential.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on review of documentation, the surveyor discovered that the personnel file for one (1) staff member (DOH: 02/20/24) did contain documentation of a negative tuberculin result. Staff-in-charge stated that the staff member had given her a copy of the staff member's negative tuberculin result; however, the documentation had been misplaced. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 5 Inspection Report Programming Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on review of documentation, The surveyor discovered the following: 1. The weekly lesson plan located in the Infants Classroom was dated 01/17/24. 2. The weekly lesson plan located in the One’s A Classroom was dated 03/11/24. No information was filled in for the lesson plan other than the date. 3. The weekly lesson plan located in the Two’s Classroom was dated 01/29/24. 4. The weekly lesson plan located in the Three’s B Classroom was dated 02/26/24 – 03/01/24. Therefore, the child-care center failed to post a current lesson plan for the classrooms.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 3. General Requirements.

General: Based on observation and review of documentation, the surveyor discovered the following while conducting the initial walk-through at the child-care center: 1. The children in the Three’s B Classroom were watching Tom and Jerry at 10:29 am when the surveyor entered the classroom. The daily planned program indicated 10:00 am-10:30 am as Outside/Play Time and 10:30 am-11:00 am as Clean up from Outside/Indoor Free Play. Television time was not listed as part of the planned programming for the classroom and the observed program was not designed as an educational tool for the children. 2. The children in the Two’s Classroom were watching television at 10:33 am when the surveyor entered the classroom. The surveyor asked the staff member what the program was that playing on the television and the staff member advised stated it was a show titled Blippy. The daily planned program indicated 10:15 am -10:45 am Outside/Play Time. Television time was not listed as part of the planned programming for the classroom. Therefore, the screen time was not part of the classroom’s daily planned programming. Premises Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation, the surveyor discovered the following: 1. The diaper changing station used for the One’s A Classroom was located inside the classroom and was not immediately adjacent to the sink. To wash hands after diaper changes, staff would have to open a half-door and enter into an area that adjoins the classroom. 2. The diaper changing station used for the Two’s Classroom was located inside the classroom and was not immediately adjacent to the sink. To wash hands after diaper changes, staff would have to open a half-door and enter into an area that adjoins the classroom. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 5 Inspection Report Hygienic Practices Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 3. General Requirements.

General: Based on observation, the surveyor witnessed the following while conducting the initial walk-through at the child-care center: 1. A staff member in the Two’s Classroom changed a child’s diaper and failed to wash the child’s hands afterwards. 2. A staff member in the One’s A Classroom changed a child’s diaper and failed to wash the child’s hands afterwards. Therefore, staff members failed to clean the children's hands after diaper changes using liquid soap and warm water as required.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 3. General Requirements.

General: Based on observation, the surveyor observed the following while conducting the initial walk-through at the child-care center: 1. A staff member in the Two’s Classroom changed a child’s diaper and failed to wash her hands afterwards. 2. A staff member in the One’s A Classroom changed a child’s diaper and failed to wash her hands afterwards. Therefore, staff failed to clean their hands with liquid soap and warm water after diaper changes as required.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation, the surveyor witnessed the following while conducting the initial walk-through of the child-care center: 1. A staff member in the Two’s Classroom changed a child’s diaper and failed to disinfect the diapering changing surface. 2. A staff member in the One’s A Classroom changed a child’s diaper and failed to disinfect the diapering changing surface. Therefore, staff failed to disinfect the diaper changing surface after each child was diapered as required. Equipment In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 4 of 5 Inspection Report Food Service Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 9. Food and Drink Requirements for All Child-Care Centers.

General: Based on review of documentation, the surveyor discovered that the daily schedule for the Two’s Classroom, Three’s A Classroom, and the Three’s B Classroom indicated that lunch ends at 11:45 am and that snack would start being served at 3:00 pm. Therefore, from the end of lunch being served to the beginning of the snack being served is more than three (3) hours. Posted Documentation In Compliance

Open Not marked corrected in the state record

Category: nutrition. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 7. First Aid and Medicine.

General: Based on review of documentation of staff member's personnel files and ECE-TRIS, the surveyor learned that a staff member (DOB: 02/22/2023) did not receive training on first aid and cardiopulmonary resuscitation (CPR). Staff-in-charge reported that she would ensure that the staff member completes their CPR training.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on review of documentation of staff member's personnel files, the surveyor discovered the following: 1. A staff member's (DOH: 02/20/2024) file did not contain proof of education documentation. 2. A staff member's (DOH: 02/13/2024) file did not contain proof of education documentation. Staff-in-charge reported that she would the staff members bring in their proof of education documentation. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 4 Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on review of documentation of the staff member's personnel files, the surveyor learned the following: 1. A staff member's (DOH: 02/20/2024) file did not contain a copy of a statement from a health professional stating that the individual was free of active tuberculosis or a copy of a negative tuberculin (TB skin test) result. 2. A staff member's (DOH: 08/29/2023) file did not contain a copy of a statement from a health professional stating that the individual was free of active tuberculosis or a copy of a negative TB skin test result. 3. A staff member's (DOH: 02/12/2024) file did not contain a copy of a statement from a health professional stating that the individual was free of active tuberculosis or a copy of a negative TB skin test result. Staff-in-charge reported that she would have staff members bring in their TB skin tests.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on review of documentation in the staff member's personnel files and ECE-TRIS, the surveyor learned the following: 1. A staff member (DOH: 01/14/2022) completed six (6) of the required fifteen (15) hours of cabinet-approved early care and education training completed between 01/14/2022 and 01/13/2023. 2. A staff member (DOH: 02/22/2023) did not complete the required six (6) hours of cabinet-approved orientation within the first three (3) months of employment in a child-care program. 3. A staff member (DOH: 03/27/2023) did not complete the required six (6) hours of cabinet-approved orientation within the first three (3) months of employment in a child-care program. 4. A staff member (DOH: 08/21/2023) did not complete the required six (6) hours of cabinet-approved orientation within the first three (3) months of employment in a child-care program. Staff-in-charge reported that she would have staff complete their trainings. Programming In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 4 Inspection Report Premises Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 4. Premises Requirements.

General: Based on observation, the surveyor discovered the following: Three-Year-Old Classroom: 1. There was what appeared to be food particles on the floor; therefore, the floor was not kept cleaned. Three-Year-Old Restroom: 1. There was a layer of dust on the exhaust fan. Two-Year-Old Classroom: 1. There was what appeared to be food particles on the floor; therefore, the floor was not kept cleaned. One-Year-Old Classroom: 1. There was dirt debris on the floor; therefore, the floor was not kept cleaned. Staff-in-charge reported that she would have the areas cleaned.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 4. Premises Requirements.

General: Based on observation, the surveyor discovered the following: One-Year-Old Classroom: 1. There were two (2) ceiling tiles that had a brown substance; therefore, the ceiling tiles were not in good repair. Preschool Classroom: 1. There were two (2) ceiling tiles that had a brown substance; therefore, the ceiling tiles were not in good repair. 2. There was an approximate ten (10) inch crack in the outer wall. Three-Year-Old Classroom: 1. There was a ceiling tile that had a brown substance; therefore, the ceiling tile was not in good repair. Staff-in-charge reported that she would have the ceiling tiles replaced and the wall repaired. Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable Kitchen Requirements In Compliance Food Service In Compliance Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals Not Applicable Children's Records Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.

General: Based on review of documentation of the children's files, the surveyor learned the following: 1. A child's (DOE: 09/13/2023) file contained an immunization certificate valid until 02/13/2024; therefore, the immunization certificate was no longer valid. 2. A child's (DOE: 07/31/2023) file contained an immunization certificate valid until 08/13/2023; therefore, the immunization certificate was no longer valid. 3. A child's (DOE: 03/01/2021) file contained an immunization certificate valid until 02/13/2024; therefore, the immunization certificate was no longer valid. Staff-in-charge reported that she would have the parents bring updated immunization certificates for the children's files. Written Documentation In Compliance Posted Documentation In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 4 Inspection Report Animals Not Applicable

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on interview with staff, the surveyor learned that one (1) staff member was supervising nine (9) one-year-old children in the One Year Old Classroom on 09/25/23 from approximately 7:00 a.m. until approximately 9:00 a.m. Based on review of the attendance record for 09/25/23, the surveyor found that nine (9) children were signed in between the timeframe of 7:00 a.m. - 9:00 a.m. Through interview with staff, the surveyor learned one (1) staff member was in the classroom at 7:00 a.m. and another staff member arrived in the classroom at 9:00 a.m. Staff stated that the children in the classroom were all one-year-old children. Therefore, the staff-to-child ratio was exceeded by three (3) children. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report General Administration Not In Compliance

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 8. General.

General: Based on interview with staff, the surveyor learned that it was discovered at pick up that a one-year-old child had fecal matter on his private area. Through interview, the surveyor learned the one-year-old child had fecal matter around his private area and his private area was very red and very irritated. During interview, staff-in-charge stated "obviously the diaper had been on the one-year-old child longer than I would have liked," and "I don't deny the diaper set on the one-year-old child longer than I hoped for." Staff-in- charge stated she thinks the soiled diaper was left on the one-year-old child for thirty (30) minutes. The surveyor was provided pictures by the Department of Community Based Services (DCBS) that showed the one-year-old child's private area. The surveyor observed the child's private area to be red, appear swollen, and have what appeared to be a small boil. The surveyor observed dried feces smeared on the child's upper inner thigh and slightly above the private area. Due to the items mentioned above, the one-year-old child's health, safety, and comfort was compromised. Hygienic Practices Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Toilet, Diapering, and Toiletry Requirements.

General: Based on interview with staff, the surveyor learned that it was discovered at pick up that a one-year-old child had fecal matter on his private area. Through interview, the surveyor learned the one-year-old child had fecal matter around his private area and his private area was very red and very irritated. During interview, staff-in-charge stated "obviously the diaper had been on the one-year-old child longer than I would have liked," and "I don't deny the diaper set on the one-year-old child longer than I hoped for." Staff-in- charge stated she thinks the soiled diaper was left on the one-year-old child for thirty (30) minutes. The surveyor was provided pictures by the Department of Community Based Services (DCBS) that showed the one-year-old child's private area. The surveyor observed the child's private area to be red, appear swollen, and have what appeared to be a small boil. The surveyor observed dried feces smeared on the child's upper inner thigh and slightly above the private area. Based on the information above, the one-year-old child's diaper was not changed when soiled or wet.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 8. General.

General: Based on observation, the surveyor discovered the following: 1. A plunger was placed on the floor of the restroom located near the Preschool Classroom. 2. A toilet bowl brush was placed on the floor of the restroom located near the Preschool Classroom. 3. A toilet bowl brush was placed by the toilet in the restroom located near the 2-Year-Old Classroom. Staff-in-charge confirmed that the restrooms are used for children; therefore, the items were accessible to the children causing a potential health and safety issue for the children. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 4 Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 13. Reports.

General: Based on observation, the surveyor was driving to the child-care center to conduct the renewal inspection when the surveyor observed an outdoor area with a playground near the child-care center. The surveyor observed what appeared to be preschool aged children playing on and around a large climbing structure on the playground. While the surveyor was performing a head count during the initial walk through of the child-care center, the surveyor observed children returning from the playground to the Threes Classroom. During interview with staff, staff reported a total of eleven (11) three-year-old children. During the surveyor’s visit, the staff-in-charge indicated she would like to add a playground to the child-care center’s license. During a walkthrough of the playground with the staff-in- charge, the surveyor observed the play structure that the Threes Classroom was playing on did not have a protective surface / fall zone equal to the height of the equipment. The surveyor observed an approximate seven (7) to ten (10) feet opening at the playground’s entrance; therefore, the playground did not have a fence that surrounds the perimeter of the playground. The surveyor advised the staff-in-charge that the children cannot use the playground until a surveyor has completed an inspection; therefore, the child-care center failed to provide written notification of the addition of square footage to the child-care center’s premises prior to allowing children to utilize the playground. The surveyor advised the staff-in-charge to request an inspection to add the playground. Director Requirements Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 10. Director Requirements and Responsibilities.

General: Based on review of documentation, the surveyor discovered that the personnel files for four (4) staff (DOH: 1/14/2022, 10/25/2021, 10/12/2020, & 3/17/2021) contained a written performance evaluation template with the employee’s name written on it; however, the document was not completed. The surveyor was unable to determine if the written performance evaluations were completed annually. Employee Records Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 7. First Aid and Medicine.

General: Based on review of documentation, the surveyor discovered that no date was entered in ECE-TRIS indicating that four (4) staff (DOH: 7/6/2022, 5/2/2022, 8/9/2022 & 1/9/2023) had received training on first aid and cardiopulmonary resuscitation (CPR). During review of the staff's personnel files, the surveyor did not find documentation indicating that the staff had completed the training on first aid and cardiopulmonary resuscitation (CPR); therefore, the child-care center failed to ensure that every staff member has received training on first aid and cardiopulmonary resuscitation (CPR) as required. Staff-in-charge stated that she was unsure if staff had previously received training on first aid and cardiopulmonary resuscitation (CPR). An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 4 Inspection Report

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on review of documentation, the surveyor discovered the following: 1. No date was listed on the ECE-TRIS Individual Training Record Report for three (3) staff (DOH: 8/29/2022, 7/6/2022, & 1/9/2023) indicating that the staff completed six (6) hours of cabinet-approved orientation training. During review of staff's personnel files, the surveyor did not find documentation indicating that staff completed orientation training. 2. No date was listed on the ECE-TRIS Individual Training Record Report for two (2) staff (DOH: 1/14/2022 & 10/25/2021) indicating that the staff completed one and one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma training. During review of staff's personnel files, the surveyor did not find documentation indicating that staff completed cabinet-approved pediatric abusive head trauma training; therefore, the surveyor was unable to determine if the staff person completed the PAHT training every five years as required. 3. Upon review of the ECE-TRIS Required Training Hours Report for the timeframe of 7/1/21 thru 6/30/22, the surveyor discovered that one (1) staff (DOH: 10/11/2021) had completed thirteen (13) hours of the fifteen (15) required hours of cabinet-approved early care and education training. 4. Upon review of the ECE-TRIS Required Training Hours Report for the timeframe of 7/1/21 thru 6/30/22, the surveyor discovered that one (1) staff (DOH: 1/14/2022) had completed six (6) hour of the fifteen (15) required hours of cabinet-approved early care and education training. 5. Upon review of the ECE-TRIS Required Training Hours Report for the timeframe of 7/1/21 thru 6/30/22, the surveyor discovered that one (1) staff (DOH: 10/25/2021) had completed six (6) hour of the fifteen (15) required hours of cabinet-approved early care and education training. 6. Upon review of the ECE-TRIS Required Training Hours Report for the timeframe of 7/1/21 thru 6/30/22, the surveyor discovered that one (1) staff (DOH: 3/17/2021) had completed seven (7) hour of the fifteen (15) required hours of cabinet-approved early care and education training. 7. Upon review of the ECE-TRIS Required Training Hours Report for the timeframe of 7/1/21 thru 6/30/22, the surveyor discovered that one (1) staff (DOH: 10/12/2020) failed to complete any of the required fifteen (15) hours of cabinet-approved early care and education training. Therefore, the child-care center failed to ensure that training was completed as required. Programming In Compliance Premises Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 4. Premises Requirements.

General: Based on observation, the surveyor observed the following: 1. Two (2) ceilings tiles with a discolored water spot located in the restroom near the Three Year Old's restroom. 2. One (1) ceiling tile with a discolored water spot located in the restroom near the Preschool Classroom. 3. Holes in the wall that appeared to be from something being mounted to the wall of the restroom located near the Preschool Classroom. Therefore, the ceilings and walls were not in good repair. Hygienic Practices Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation, the surveyor discovered that a soiled pull-up was placed in an uncovered trash can located in the Boys restroom located near the Two Year Old Classroom; therefore, the soiled item was not stored in a covered container as required. First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable Kitchen Requirements In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 4 Inspection Report Food Service In Compliance Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals In Compliance Children's Records In Compliance Written Documentation Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.

General: Based on review of documentation, the surveyor discovered the following: 1. The personnel files for two (2) staff (DOH: 10/11/2021 & 10/25/2021) contained a written annual professional development plan; however, the written professional development plan had not been completed. 2. The personnel file for one (1) staff (DOH: 3/17/2021) contained a written annual professional development plan dated 6/10/2021. 3. The personnel file for two (2) staff (DOH: 10/12/2020 & 1/14/2022) did not contain a written annual professional development. Therefore, the surveyor was unable to determine if the annual professional development plans were completed as required. Posted Documentation In Compliance Animals In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:280 · 922 KAR 2:280. Section 3. Implementation and Enforcement.

General: Based on review of documentation, the surveyor found the following: 1. A staff’s (DOH: 10/12/2020) file did not contain documentation of background checks submitted through the Kentucky National Background Check Service. Based on review of the Kentucky National Background Check Service, the staff member did not have a completed background check; therefore, the staff person was hired prior to clearance for employment. The staff’s file contained a completed Child Abuse/Neglect Background Check (CAN) dated for 07/09/2020 and a Criminal Records Background Check (CRC) dated for 06/09/2020. During interview, staff reported that she was unaware that the staff person's background check was not submitted through the Kentucky National Background Check Service. Staff stated that the staff person has not worked alone with children. The surveyor did not observe the staff person working during the surveyor’s visit. 2. A staff’s (DOH: 03/17/2021) file did not contain documentation of background checks submitted through the Kentucky National Background Check Service. Based on review of the Kentucky National Background Check Service, the staff member did not have a completed background check; therefore, the staff person was hired prior to clearance for employment. The staff’s file contained a completed Child Abuse/Neglect Background Check (CAN) dated for 04/20/2021 and a Criminal Records Background Check (CRC) dated for 04/29/2021. During interview, staff reported that she was unaware that the staff person's background check was not submitted through the Kentucky National Background Check Service. Staff stated that the staff person has not worked alone with children. The surveyor did observe the staff person working during the surveyor’s visit; however, the staff was not working alone. Supervision In Compliance Staffing Requirements In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 5 Inspection Report General Administration Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 8. General.

General: Based on observation, the surveyor found the following: 1. A child was sleeping on a rug located in the middle of the floor in the One Year Old Classroom; therefore, the child care center failed to assure the comfort of the child. During interview, staff reported that the child rolled off their mat. The surveyor did not observe a mat within close proximity to the child and the surveyor overheard a staff request a mat for the child. 2. A child was sleeping on a rug located in the floor of the Two Year Old Classroom; therefore, the child care center failed to assure the comfort of the child. During interview, staff reported the child would lay down anywhere to fall asleep. The surveyor overheard a staff request a mat for the child. Staff reported she would talk with staff about ensuring children have mats during naptime. Director Requirements Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 10. Director Requirements and Responsibilities.

General: Based on review of documentation, the surveyor found that a staff's (DOH: 11/26/2020) file did not contain a staff evaluation. During interview, staff reported that she did not know if the staff had a completed evaluation. Employee Records Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on review of documentation, the surveyor found the following: 1. A staff's (DOH: 10/18/2021) file did not contain a high school diploma, GED, or Commonwealth Child Care Credential; therefore, the surveyor was unable to verify staff's education. 2. A staff's (DOH: 09/28/2021) file did not contain a high school diploma, GED, or Commonwealth Child Care Credential; therefore, the surveyor was unable to verify staff's education. 3. A staff's (DOH: 08/31/2021) file did not contain a high school diploma, GED, or Commonwealth Child Care Credential; therefore, the surveyor was unable to verify staff's education. Staff reported that she would have the staff bring in their education documentation for the files.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on observation, the surveyor found the following: 1. A staff's (DOH: 10/18/2021) file did not contain a copy of a statement from a health professional stating that the individual was free of active tuberculosis or a copy of a negative tuberculin result for the staff person; therefore, the surveyor was unable to verify if the staff person was free of active tuberculosis. 2. A staff's (DOH: 09/28/2021) file did not contain a copy of a statement from a health professional stating that the individual was free of active tuberculosis or a copy of a negative tuberculin result for the staff person; therefore, the surveyor was unable to verify if the staff person was free of active tuberculosis. 3. A staff's (DOH: 01/14/2021) file did not contain a copy of a statement from a health professional stating that the individual was free of active tuberculosis or a copy of a negative tuberculin results for the staff person; therefore, the surveyor was unable to verify if the staff person was free of active tuberculosis. Staff reported that she would have the staff bring in proof of their TB skin test. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 5 Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on review of documentation and ECE-TRIS, the surveyor found the following: 1. Staff (DOH: 11/26/2020) completed one (1) of the required fifteen (15) hours of cabinet-approved early care and education training completed between 11/26/2020 through 11/25/2021. 2. Staff (DOH: 11/26/2020) did not complete the required six (6) hours of cabinet-approved orientation within their first three (3) months of employment. 3. Staff (DOH: 09/28/2021) did not complete the required six (6) hours of cabinet-approved orientation within their first three (3) months of employment. 4. Staff (DOH: 10/18/2021) did not complete the required six (6) hours of cabinet-approved orientation within their first three (3) months of employment. 5. Staff (DOH: 08/31/2021) did not complete the required six (6) hours of cabinet-approved orientation within their first three (3) months of employment. 6. Staff (DOH: 10/25/2021) did not complete the required six (6) hours of cabinet-approved orientation within their first three (3) months of employment. Staff reported she is working with staff to get their training hours. Programming Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 6. Sleeping and Napping Requirements.

General: Based on observation, during a tour of the child-care center the surveyor observed the following: 1. An infant sleeping in a swing with a bottle and blanket located in the Infant Classroom. 2. An infant sleeping in a swing with a blanket located in the Infant Classroom. During interview, staff reported the infants had been asleep for about ten (10) minutes. Premises Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 4. Premises Requirements.

General: Based on observation, the surveyor observed dirt and paper debris on the rug located in the Three and Four Year Old Classroom. Staff reported she would have the rug cleaned. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 5 Inspection Report Hygienic Practices Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation, the surveyor found the following: 1. The diaper changing pad located in the One Year Old Classroom contained a brown substance; therefore, the diaper changing pad was not clean. 2. The diaper changing pad located in the Two Year Old Classroom contained tears; therefore, the diaper changing pad was not in good repair. 3. The diaper changing pad located in the Three and Four Year Old Classroom contained tears; therefore, the diaper changing pad was not in good repair. Staff reported she would replace the diaper changing pads. First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 6. Sleeping and Napping Requirements.

General: Based on observation, the surveyor observed two (2) sleeping mats with ripped edges in the Three and Four Year Old Classroom; therefore, the mats were not in good repair. Staff reported she would replace the mats.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 13. Toys and Furnishings.

General: Based on observation, the surveyor discovered on the playground a minnie mouse riding toy with a broken steering wheel; therefore, the toy was not in good repair. Staff reported that she would have the toy removed. Transportation Not Applicable Kitchen Requirements Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 8. Kitchen Requirements.

General: Based on observation, the surveyor found two (2) uncovered bottles with a liquid substance on a shelf in the Infant Classroom. Staff reported she would ensure that bottles are covered when they are not being used. Food Service In Compliance Meal Planning/Center Provides Meals In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 4 of 5 Inspection Report Meal Planning/Center Does Not Provide Meals Not Applicable Children's Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.

General: Based on review of documentation, the surveyor found the following: 1. A child's (DOE: 07/07/2021) file contained an immunization certificate dated for 02/10/2022; therefore, the immunization certificate was not current. 2. A child's (DOE: 12/08/2020) file contained an immunization certificate dated for 02/15/2021; therefore, the immunization certificate was not current. 3. A child's (DOE: 02/09/2021) file did contained an immunization certificate dated for 10/04/2021; therefore, the immunization certificate was not current. 4. A child's (DOE: 01/10/2022) file contained an immunization certificate dated for 06/18/2021; therefore, the immunization certificate was not current. 5. A child's (DOE: 01/05/2022) file contained a list of immunization and did not contain an actual immunization certificate; therefore, the surveyor was unable to determine if immunizations were current. 6. A child's (DOE: 12/10/2021) file did not contain an immunization certificate; therefore, the surveyor was unable to determine if immunizations were current. Staff reported she would update the children’s immunization certificates in their files. Written Documentation In Compliance Posted Documentation In Compliance Animals Not Applicable

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.